中性粒细胞明胶酶转运蛋白对重症患者急性肾损伤的早期诊断价值  

The value of NGAL in the early diagnosis of severe acute renal injury

作　　者：张根花[1] 俞禾涛[1] 胡岗[2] 陈弘磊 

机构地区：[1]浙江省立同德医院检验科,浙江杭州310007 [2]浙江省立同德医院肾病科,浙江杭州310007

出　　处：《中国卫生检验杂志》2017年第22期3266-3268,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨中性粒细胞明胶酶转运蛋白(NGAL)水平变化对于早期诊断重症患者并发急性肾损伤(AKI)的临床价值。方法选取2015年1月-2016年12月在本院肾病科的150例患者进行回顾性研究,根据患者入住肾病科期间是否并发AKI分为AKI组39例、非AKI组111例,对比2组患者入住肾病科时、入住后第3 d、入住后第5 d、入住后第7 d的血清及尿液中NGAL水平。结果 AKI组在入住后第3 d、入住后第5 d、入住后第7 d的血清、尿液NGAL逐渐升高且高于同一时间点非AKI组患者;AKI组在入住肾病科时尿NGAL高于非AKI组患者,差异均有统计学意义(P<0.05)。入院第3 d尿NAGL、血清NAGL诊断AKI的临界值分别为1 908.3μg/L、44.6μg/L,对应的灵敏度分别为83.26%、77.27%,特异度分别为86.14%、80.06%,曲线下面积分别为0.848、0.794。结论重症患者肾损害早期即出现血液及尿液中NAGL水平的升高,并且能够反映患者肾功能的变化趋势。Objective To investigate the clinical value of neutrophil gelatinase transfer protein（ NGAL） levels in the early diagnosis of critical acute renal injury（ AKI） patients. Methods A retrospective study was conducted on 150 patients with nephrology in our hospital from January 2015 to December 2016. According to whether the patients were complicated with AKI during the nephrology period,they were divided into AKI group（ 39 cases） and non-AKI group（ 111 cases）. The levels of NGAL in serum and urine were detected on the admission,the 3 rdd,5 thd,and 7 thd after admission. Results In the AKI group,serum and urinary NGAL levels increased gradually and were higher than those in the non-AKI group on the 3 rdD,the 5 thD,and the 7 thD.In the AKI group,urinary NGAL level was higher than non-AKI patients on the admission,and the difference was statistically significant（ P 〈0. 05）. The critical values of NAGL on 3 rdD after admission and NAGL in serum were 1 908. 3 μg/L and44. 6 μg/L,respectively,with corresponding sensitivity of 83. 26% and 77. 27%,specificity of 86. 14% and 80. 06% respectively. Area under curve was respectively 0. 848 and 0. 794. Conclusion Serum and urine NAGL levels are elevated in the early stage of renal impairment in critically ill patients,and can reflect the changing trend of renal function in patients.

关 键 词：中性粒细胞明胶酶转运蛋白 重症 急性肾损伤 

分 类 号：R541.4[医药卫生—心血管疾病]